Medicine and Phlebolymphology: Time to Change?
| العنوان: | Medicine and Phlebolymphology: Time to Change? |
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| المؤلفون: | Attilio Cavezzi |
| المصدر: | Journal of Clinical Medicine, Vol 9, Iss 4091, p 4091 (2020) Journal of Clinical Medicine |
| بيانات النشر: | MDPI AG, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | integrative medicine, medicine.medical_specialty, Cost effectiveness, lcsh:Medicine, Review, 030204 cardiovascular system & hematology, compression therapy, Scientific evidence, Health administration, surgery, 03 medical and health sciences, 0302 clinical medicine, Health care, sclerotherapy, medicine, 030212 general & internal medicine, varicose veins, Intensive care medicine, cost-effectiveness, business.industry, lcsh:R, Translational medicine, chronic venous diseases, General Medicine, Evidence-based medicine, lymphedema, Pelvic congestion syndrome, medicine.disease, venous ulcer, endovenous treatments, vein thrombosis, Integrative medicine, business |
| الوصف: | Biomedical science is undergoing a reappraisal of its scientific advancement process and of the related healthcare management. Progress in medicine should combine improvements of knowledge, efficacy, and safety of diagnostic/therapeutic procedures, with adequate cost-effectiveness profiles. This narrative review is aimed at assessing in medicine, more specifically in phlebology and lymphology: (a) scientific literature possible biases, (b) the level of evidence, comprehensiveness, and cost-effectiveness of the main therapeutic options, and (c) the possible contribution of integrative and translational medicine. Current medical research may have cognitive biases, or industry-tied influences, which impacts clinical practice. Some reductionism, with an increasing use of drugs and technology, often neglecting the understanding and care of the root causative pathways of the diseases, is affecting biomedical science as well. Aging brings a relevant burden of chronic degenerative diseases and disabilities, with relevant socio-economic repercussions; thus, a major attention to cost-effectiveness and appropriateness of healthcare is warranted. In this scenario, costly and innovative but relatively validated therapies may tend to be adopted in venous and lymphatic diseases, such as varicose veins, leg venous ulcer, post-thrombotic syndrome, pelvic congestion syndrome, and lymphedema. Conversely, a more comprehensive approach to the basic pathophysiology of chronic venous and lymphatic insufficiency and the inclusion of pharmacoeconomics analyses would benefit overall patients’ management. Erroneous lifestyle and nutrition, together with chronic stress-induced syndromes, significantly influence chronic degenerative phlebo-lymphatic diseases. The main active epigenetic socio-biologic factors are obesity, dysfunctions of musculo-respiratory-vascular pumps, pro-inflammatory nutrition, hyperactivation of stress axis, and sedentarism. An overall critical view of the scientific evidence and innovations in phebolymphology could be of help to improve efficacy, safety, and sustainability of current practice. Translational and integrative medicine may contribute to a patient-centered approach. Conversely, reductionism, eminence/reimbursement-based decisional processes, patients’ lack of education, industry-influenced science, and physician’s improvable awareness, may compromise efficacy, safety, appropriateness, and cost-effectiveness of future diagnostic and therapeutic patterns of phlebology and lymphology. |
| تدمد: | 2077-0383 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::228e51664a8b54a5e748f20a04971f86 https://doi.org/10.3390/jcm9124091 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....228e51664a8b54a5e748f20a04971f86 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20770383 |
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